10. Early EEG/SEPs recordings are reliable predictors of good and poor outcome in comatose patients after cardiac arrest

Abstract

Somatosensory evoked potentials (SEPs) are reliable predictor of poor outcome in comatose patients after cardiac arrest (CA) treated with therapeutic hypothermia (TH). Recently the role of EEG in determining the prognosis have been reassessed. A continuous EEG pattern within 12 after CA, reliably predicts awakening. Our aim was to evaluate the role of EEG and SEPs recorded during first 12 h after CA in prediction of outcome. In a cohort of comatose adults resuscitated from CA treated with TH EEG and SEPs were recorded within 12 h and at 24 h after CA. EEG was classified according to Cloostermans et al. (2012); SEPs was classified as bilaterally absent (BA) and present. Neurologic outcome has been assessed at least after 6 months by GOS. Seventy-two patients were included and 25 were recorded before 12 h from CA. All patients who showed a continuous EEG pattern within 12 h awakened. The same EEG pattern recorded at 24 h is not always predictive of awakening. BA SEPs within 12 h were always associated to following EEG patterns: isoelectric, low-voltage and burst-suppression. Early EEG/SEPs recordings are useful tools for reliable prognostication both of good and poor outcome in comatose patients treated with TH.